Abbi and Ilana do it. So does the Guy. Gwyneth is all about it. [From popular documentaries such as Fantastic Fungi to terrifying horror films such as Midsommar, pop culture is positively bewitched by psychedelics.
The latest installation in Hollywood’s psychedelics infatuation is the Hulu series Nine Perfect Strangers. Nicole Kidman plays Masha, an intense wellness "guru" who runs a retreat called Tranquillum House. As her guests begin to engage in treatment, they realize that Masha has been dosing them with psilocybin — the active ingredient in magic mushrooms — without their knowledge or consent.
As a therapist with over a decade of experience in the field, I wanted to dig a bit deeper into how psychedelics are utilized within retreat settings today. These places do exist, but Nine Perfect Strangers presents a deranged portrait of what psychedelic wellness retreats look like in reality.
In almost every scene, Masha is a walking ethics violation in a bad wig. She engages in sexual relationships with several members of her staff; she sneaks into her guests’ rooms in the middle of the night; and she neglects to inform them when she begins dosing them with psilocybin, concealed in their colorful morning smoothies.
While the idea of dosing individuals with any substance without consent is an abhorrent ethical violation — not to mention a felony. Still, after finding out, all nine of the guests ultimately decide to continue their course of treatment. As they get used to the idea of engaging in psychedelic-assisted group therapy, one guest refers to Tranquillum as the “Betty Ford clinic in reverse.”
That’s clever, but reductive. Even though using psychedelics to treat mental health issues might seem counterintuitive to those unfamiliar with the emerging practice, it’s revolutionary science for patients who haven’t had success with more traditional treatment. Clinical trials using psilocybin to treat PTSD and depression are underway, and it’s a practice that is likely to enter the mainstream sooner than most might think.
Michael Mithoefer, senior medical director for medical affairs, training, and supervision at the Multidisciplinary Association for Psychedelic Studies (MAPS), has been an integral figure in the process to advance research for MDMA-assisted therapy and expresses optimism about its future. He clarifies the timeline, as he sees it: Research into both MDMA (aka: “Molly”) and psilocybin (aka: “shrooms” or “magic mushrooms”), are currently in Phase 3 in the United States, which is the final phase prior to submission for FDA approval. “So if all goes well, by the end of 2023, MDMA could become an approved medicine,” Mithoefer adds.
But because the treatment is new, it’ll be done under the guidance of an actual physician — not a dewy wellness “guide” like Masha. “Giving somebody one of these medicines without their consent runs entirely counter to everything we think is important about these medicines. […] It’s all about respect and collaborative relationships and taking your lead from the participant. You’re not going to have that kind of relationship if you trick somebody,” Mithoefer says.
Janis Phelps, director of the Center for Psychedelic Therapies and Research at the California Institute for Integrative Studies, is also confident that psychedelics are on their way to becoming approved medicines. She says, “We expect their approval over the next several years. MDMA-assisted therapy for post-traumatic stress disorder (PTSD) is closest to FDA approval, and psilocybin-assisted therapy for depression is close behind.”
Once the FDA approves them, Phelps believes that, “there will be a flood of people seeking these treatments.” Many mental health medications focus on managing symptoms, but psychedelics such as psilocybin show enormous promise in potentially eliminating symptoms altogether, and perhaps even curing a person entirely. Therefore, there is a great, pent up demand for these medications.
Phelps foresees a future where these therapies will be used in many different contexts, including group, individual, and couples therapy. She notes that, “when administered by therapists with appropriate training, [psychedelics] can augment a wide range of therapeutic approaches.” And she “absolutely” believes that wellness retreats that offer psychedelic-assisted therapy would potentially be beneficial to those seeking this type of treatment as well.
Wellness retreats offering psychedelic-assisted therapy already exist all over the world. Interested parties can hop on a flight to countries where these substances are currently legal, such as Jamaica or Costa Rica, and find locations that offer guided trips with luxurious beachside accommodations. The U.S. is already home to a handful of ayahuasca retreats that exist due to religious exemptions. But with the FDA poised to approve psychedelics such as MDMA and psilocybin for therapeutic use, it’s a distinct possibility that retreats offering these additional substances could also start popping up legally in the U.S. within the next five to 10 years.
Justin Townsend, the CEO of psychedelic-assisted retreat MycoMeditations in Jamaica, tells Mic that the company is “watching the U.S. cautiously. We know that psilocybin has been given breakthrough status by the FDA, so I think it’s only a matter of two, three, four years until, on a state-by-state basis, psilocybin will be available. Certainly, we have plans to enter the U.S. and eventually Europe as well once that’s the case.”
Here’s how a psychedelic retreat would have to go down legally in the U.S.: At least initially, individuals would need a psychiatric diagnosis in order to be prescribed a psychedelic medication — and they’d be treated individually. But down the road, Mithoefer sees “good reasons for having retreat-style treatments with groups.”
However, he cautions against treating psychedelic-assisted wellness retreats as vacations, saying, “You see people come back from these retreats, and they’re opened up, but then they’re freaking out. It can be a wonderful setting, but it’s not a vacation activity.” To reiterate, these drugs are powerful and can excavate overwhelming repressed memories and emotions. That might not be the vibe if you’re looking to relax with a bunch of friends.
And not all psychedelic-assisted retreats are created equal. Retreats can vary in terms of the experience, type of psychedelic, or location. Some follow evidence-based therapeutic models, while others focus more on shamanistic rituals built upon centuries-old traditions from healers in countries such as Peru and Costa Rica. Indigenous residents do run some of these types of retreats, but in recent years, Westerners have been flooding into these spaces and culturally appropriating traditions in the name of tourism. While this is certainly not desirable behavior, it does speak to the larger demand for psychedelics to become available in a therapeutic context stateside.
Nine Perfect Strangers combines the most screen-worthy elements of each type of retreat and, as a result, the exact Tranquillum experience (thankfully) does not exist. But for many — especially those who haven’t had success treating depression or PTSD with drugs or talk therapy — it piques curiosity.
In recent years, Westerners have been flooding into these spaces and culturally appropriating traditions in the name of tourism.
Individuals seeking an experience similar to the series should look to select their retreat carefully and ask many questions before selecting a retreat. “First off, what is the ratio of staff to guests? What is the composition of the team? Are they science-based? Are they evidence based? If you want a more shamanistic retreat, that may be a different bit of selection criteria,” Townsend says. One difference between a science-based retreat and a shamanistic retreat is that the latter is more likely to include a spiritual component, although some researchers and therapists believe that a spiritual component should be part of all psychedelic experiences.
MycoMeditations reportedly had a bumpy start with its previous founder, but Townsend says the company has evolved since that time, and that it is always actively searching for ways to integrate evidence-based practices into the retreat space. While the “vast majority of retreats out there are shamanically oriented,” some retreats, such as MycoMeditations, now offer a therapeutic experience that seeks to provide a psychoeducational piece throughout the stay. Townsend stresses the importance of covering “a lot of the neuroscience and neuropsychology, how dissolution of the ego works when people are taking these substances,” so that guests know what to expect prior to taking them.
Phelps echoes that getting what is essentially medical treatment in a retreat atmosphere will require trained professions and medical back-up if needed. Also, the experience would ideally be one part of a comprehensive mental health support system. She cautions against retreat leaders like Masha on Nine Perfect Strangers who extol the virtues of taking psychedelics alone without doing the work required of long-term treatment. She says, “Psychedelic therapy is not a magic bullet, and those seeking it should be wary of anyone who claims that it is.”
Ifetayo Harvey, founder of the People of Color Psychedelic Collective, told Mic that she advises people to research treatment providers specifically before booking a trippy trip. Harvey notes that white guests and staff predominantly populate a lot of wellness retreats, and that people of color might want to keep additional considerations in mind when traveling. “If you are under the influence of psychedelics and a memory comes up that’s related to racial trauma, are your facilitators capable of holding space for you when that stuff does come up? Or, something racist might actually happen at the retreat while you’re in ceremony. And will those people address it? Those are important things to consider.”
Psychedelics have been taken for the purposes of enlightenment and spirituality in group settings for centuries, if not millenia, in various religions and cultures. Yet, the effort to legalize (and monetize) psychedelics for therapeutic purposes has largely ignored these groups. It is currently an overwhelmingly white space, but with organizations such as the People of Color Psychedelic Collective and The Ancestor Project leading the way, progress is being made.
Mithoefer echoes Harvey’s sentiment: “If you’re going to go to a retreat, check out the retreat very carefully. Not only to see if they are doing it in an informed way, but also to see if there are any reports of inappropriate behavior. Because I think [when] people are in vulnerable states, there’s a danger of an unethical therapist taking advantage and having poor boundaries.”
Another important consideration is how to approach the bookends of the trip. Mithoefer encourages people to get hooked up with a therapist, preferably one with psychedelic integration training, prior to traveling. He says, “it may help you get more growth and healing from what you did experience.” If the wellness retreat has an integrated aftercare program, that can be helpful as well.
In addition, Mithoefer cautions people to be very careful if they're on any medications, as these could interact with psychedelics. “I would check with a physician who is knowledgeable in this area, make sure you have no medical contraindications and that you’re not on any medicines that would be dangerous,” he adds.
Looking at the world of Nine Perfect Strangers, Masha and her team at Tranquillum check off very few of these prerequisites. Other than an unflagging belief in the medications, Masha appears to have no meaningful education or experience in the psychedelic therapy field. Once the guests realize they are being dosed, Masha defends her actions by saying, “when this gets out, it’s going to change everything.”
When we ran this quote by Mithoefer, he found it kind of grandiose, but he does believe that these types of retreats will revolutionize psychiatric and psychological treatment in many ways — especially “because it’s such a different approach of a focus on inner healing intelligence and using a medicine to catalyze the therapeutic process rather than to suppress symptoms.”
But he also (along with every other expert in this piece) cautions against treating the medications as a cure-all, saying, “The danger is that everyone suddenly thinks it’s the best thing since sliced bread, and they don’t realize that it’s not a magic bullet; it’s a valuable tool.”
“I think that mushrooms and other psychedelics can inspire us to make a change in our world, or give us vision or imagination for changing things, but when it comes to mental health we need to change things structurally,” Harvey says. “Overall, psychedelics should be seen as one of many tools that we have in our toolbox to do healing work, to do visionary work.”
In my professional opinion, I agree. So many people want the latest treatment or medication to be a quick fix for a problem, and then, when it doesn’t turn out to change everything in a brief period of time, they experience frustration.
One thing Masha gets right about the therapeutic process is that suffering is involved. Pain is — for better or worse — an inextricable part of healing, and proper healing takes time. So while you shouldn’t expect an experience at a psychedelic-assisted wellness retreat to instantaneously cure all of your ills, when done right, it can provide a crucial step on the path to healing.